Application for Admission
This free application is for Massachusetts community college students who will/have completed their
associate’s degree under MassTransfer or an Additional Transfer Agreement (ATA) in an approved
program of study, as well as those who will/have completed their associate’s degree under an Education
or Nursing Transfer Compact. Visit the MassTransfer website (www.mass.edu/masstransfer) to learn more
about the requirements and benefits of MassTransfer.
Preferred Application Filing Dates*
 Fall entrance: March 1
 Spring entrance: October 15
* If you wish to apply after these dates, please check the institutional website as transfer application dates vary by institution and certain
programs of study with competitive admission may no longer be available. Applications for financial aid, housing, early registration and/or
certain majors may have earlier deadlines than indicated.
To complete this application (please type responses or print clearly)
 Check to see if your major is offered on each institution’s website
 Complete all fields of this application and send it via postal mail to your intended institution’s admissions
office. (Contact information is on the MassTransfer website: www.mass.edu/masstransfer.) Incomplete
application forms will not be processed or accepted.
 Request an official transcript from the Registrar’s Office of your current community college and from all
colleges you previously attended (whether or not you wish to transfer credits). Have the transcript(s) sent
to your intended state university or University of Massachusetts campus.
 Once you graduate from your community college, request a final official transcript with graduation notation
from the Registrar’s Office and have it sent to your intended state university or University of Massachusetts
campus.
NOTE: some campuses may require additional information.
To qualify for the MassTransfer Tuition Waiver
 Complete your associate’s degree in a designated program with a 3.0 final GPA.
 Once you graduate from your community college, request a final official transcript with graduation notation
from the Registrar’s Office and have it sent to your intended state university or University of Massachusetts
campus.
 Enroll at a state university or University of Massachusetts campus within one academic year after
graduating from your community college.
 Maintain a 3.0 cumulative GPA, and you will be eligible to receive the tuition waiver for four consecutive
semesters at the baccalaureate institution.
 Note: Continuing Education, Evening and/or Online programs may not be eligible.
 Note: Waiver is a minimum of one-third off the in-state tuition only. Fees are not eligible for the discount.
Financial Aid
Complete and file the Free Application for Federal Student Aid (FAFSA) at www.fafsa.ed.gov by March 1.
Note: This date is earlier than the date listed on the FAFSA website to ensure that state financial aid is processed in time. Name and social
security number on the application must match that on the FAFSA or financial aid may not be processed.
Disclaimer: Students who have matriculated into another college since completing an associate degree are not eligible for
MassTransfer and must submit a traditional admission application. Students who are not in good academic, fiscal, and/or
disciplinary status at all previously attended colleges and universities who have a criminal history/record may not be
guaranteed MassTransfer benefits.
STUDENT INFORMATION - PLEASE PRINT LEGIBLY
Name:
Last/Family
First
Middle
(Other name that may appear on official
records)
State
ZIP
State
ZIP
Mailing Address:
Street Address (including apartment #, if applicable)
City
Permanent Address:
(If different from mailing)
Street Address (including apartment #, if applicable)
City
Phone/Email:
Cell Phone
Home Phone
Date of Birth (*Required):
Social Security #
(Required for
financial aid):
Gender
Female
Male
Residency:
In-State
Out-of-State
Citizenship:
Email Address
-
Veteran?
-
Yes
No
On active duty
Country of Birth:
U.S.
Permanent Resident:
Alien Registration #:
Date Issued:
Attach/send copies of both sides of alien registration card
International Student:
Visa Type:
Note: International students must meet additional visa status and financial support
requirements (vary from campus to campus). Failure to meet international admission
requirements will negate all benefits of MassTransfer.
Ethnic Information Do you consider yourself Hispanic or Latino? Yes
(optional):
Please check one or more:
American Indian or Alaskan Native
Cape Verdean
No
Asian
Multiracial
White/Non-Hispanic
Black or African American
Native Hawaiian or Other
Pacific Islander
INTENDED ENROLLMENT INFORMATION
Intended Enrollment Status:
Full-time -orDay Program -or-
Part-time
Continuing Education/Evening/Online Program*
*MassTransfer tuition waiver may not be eligible for Continuing Education/Evening/Online program enrollment
Planned Entrance:
September 20
-or-
First Choice of Major:
(*Required)
January 20
Second Choice
of Major:
(*Required)
* For education majors. Date of CLST:
Intended Housing Type:
On-Campus (not guaranteed)
Off-campus
Commuter
CURRENT ENROLLMENT INFORMATION
Current and Previous Colleges Attended You must supply official college transcripts from every school attended whether or
not transfer credit is desired or if they are listed on your community college transcript.
College/University
City/State
Dates Attended (MM-YYYY)
Degree Earned
to
to
to
Current Enrollment Status
Enrolled
Not Enrolled (skip Current Courses section)
Current Courses
Course Title
Course Number
Semester/Year
# of credits
Course Number
Semester/Year
# of credits
Anticipated Summer/Intersession Courses
Course Title
Name of High School Attended:
YOG:
*REQUIRED
Expected Date of Graduation with Associate’s Degree:
(MM-YYYY)
(MM-YYYY)
Associate’s Degree Major:
OTHER INFORMATION (optional to complete)
Financial Aid Plans Please select the option below that best describes your plans to complete a FAFSA (Free Application for
Federal Student Aid). This information will have no impact on admissions. The Financial Aid priority deadline is March 1. Your
name must appear identically on all forms.
I plan to apply for financial aid and will complete the FAFSA at www.fafsa.ed.gov
I do not plan to apply for financial aid at this time
Family Information
Have one or more of your parent(s) attended a college/university?
Yes
No
Have one or more of your parent(s) received a bachelor’s degree?
Yes
No
DISCLOSURES (all fields are required)
Have you ever been placed on disciplinary probation,
suspension, or refused readmission to any college or
university?
Yes
No
If Yes, you must enclose an explanation on a separate sheet. Note: additional
documentation may be required.
Have you ever been convicted of a misdemeanor or felony?
Yes
No
If Yes, you must enclose an explanation on a separate sheet. Note: additional
documentation may be required.
TUITION RESIDENCY
Please read the Tuition Classification information at: www.mass.edu/forstudents/admissions/residencypolicy.asp.
Please note that possession of a second home in Massachusetts does not qualify you for residency. All applicants must check
appropriate residency status:
In-state (complete Basis/Signature sections below)
Out-of-state (complete Signature section below)
Basis for in-state residency (complete if declaring in-state residency only):
I am a dependent student and at least one parent /legal guardian has resided in Massachusetts for at least
12 months prior to my planned enrollment at a four-year institution. Please provide Massachusetts parent’s/legal
guardian’s information below:
Name
Street address
City/State
Resided in MA since
Daytime phone number
(month/year)
I am an independent student and I will have lived in Massachusetts for at least 12 months prior to my planned enrollment
at a four-year institution. (Please note that time spent as a full-time student in Massachusetts may not be applied to the
12-month residency period. Four-year institutions may also require additional documentation when traditional college-age
students claim independent status.)
My parent/legal guardian (or self) is a member of the armed forces on active duty in Massachusetts.
All students must complete the following:
The institution reserves the right to withdraw without notice any application which is not complete and accurate. By my signature
below, I certify that the information I have provided about my academic and personal history and my residency is accurate and
complete. Failure to disclose any required information may result in denial of admission or retroactive administrative
withdrawal without refund or loss of course credits.
I understand that information about the applicant that is submitted will be kept confidential and that, by participating in
MassTransfer, I consent to the release of my student education records between the community college and the state university
or the University of Massachusetts campus at which I intend to enroll or to educational agencies and institutions for research
purposes.
I understand that additional forms may be required for admission and that it is my responsibility to thoroughly read
correspondence sent from the institution.
I understand that it is my responsibility to contact the community college and any other college/university I previously attended to
arrange to have my current and final transcript sent to my intended state university or University of Massachusetts campus.
Signature:
Date: